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| LETTER TO EDITOR |
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| Year : 2007 | Volume
: 55
| Issue : 1 | Page : 81 |
Expansion of traumatic intracerebral hemorrhage: Treatment implications with recombinant factor VIIa
Sudhir Kumar
Apollo Hospitals, Jubilee Hills, Hyderabad - 500 033, Andhra Pradesh, India
| Date of Acceptance | 15-Nov-2006 |
Correspondence Address:
Sudhir Kumar
Apollo Hospitals, Jubilee Hills, Hyderabad - 500 033, Andhra Pradesh
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0028-3886.30438
How to cite this article:
Kumar S. Expansion of traumatic intracerebral hemorrhage: Treatment implications with recombinant factor VIIa. Neurol India 2007;55:81 |
Sir,
I read with interest the recent article by Yadav et al .[1] They reported an expansion in hematoma volume in about 16% of cases that were re-imaged within 24 hours of the initial CT scan. Presence of coagulopathy was an important predictor of hematoma expansion.
This finding could allow the use of newer therapeutic options for traumatic intracerebral hemorrhage (ICH). Hematoma expansion is known to occur in 38% of spontaneous ICH.[2] Treatment with recombinant factor VIIa (rFVIIa) within 4 hours of symptom onset was found to be efficacious and safe in spontaneous ICH.[3] As hematoma volume and the presence of coagulopathy are important determinants of outcome in traumatic ICH,[4] therapies aimed at limiting the hematoma size and correcting the coagulopathy would be beneficial in them. In a recent case report, two patients with worsening hemorrhage on the CT scan were treated with a single dose of rFVIIa (120 mcg/Kg).[5] CT findings and coagulation parameters improved after treatment with rFVIIa in both the patients. Prospective, randomized, multicentric trials are planned to further elucidate this hypothesis.
| » References | |  |
| 1. | Yadav YR, Basoor A, Jain G, Nelson A. Expanding traumatic intracerebral contusion/hematoma. Neurol India 2006;54:377-81.  |
| 2. | Kumar S, Badrinath HR. Early recombinant factor VIIa therapy in acute intracerebral hemorrhage: Promising approach. Neurol India 2006;54:24-7. |
| 3. | Mayer SA, Brun NC, Begtrup K, Broderick J, Davis S, Diringer MN, et al . Recombinant activated factor VII for acute intracerebral hemorrhage. N Engl J Med 2005;352:777-85. |
| 4. | Choksey M, Crockard HA, Sandilands M. Acute traumatic intracerebral haematomas: Determinants of outcome in a retrospective series of 202 cases. Br J Neurosurg 1993;7:611-22. [PUBMED] |
| 5. | White CE, Schrank AE, Baskin TW, Holcomb JB. Effects of recombinant activated factor VII in traumatic nonsurgical intracranial hemorrhage. Curr Surg 2006;63:310-7. [PUBMED] [FULLTEXT] |
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